When Should Couples Present With Suspected Infertility

If the couple cannot predict the days of ovulation, in other words if the menstrual periods are not regular; or if the woman has history of a disease or intervention potentially causing poor ovarian reserve (history of ovarian cysts, previous ovarian surgery for torsion of the ovary or any other causes, history of chemotherapy or radiotherapy, family history of early menopause, etc.); or if the women is older than 35 years old; the couple should present for an evaluation to an IVF specialist as soon as possible if they cannot achieve pregnancy on a 6-month course of regular sexual intercourse without contraception.

Any of the following should raise a suspicion of infertility, requiring an evaluation by an IVF specialist.

• Menstrual irregularities or having no menstruation at all
• Severe pain during menstrual periods (dysmenorrhea), painful menstruation, and intense and excessive bleeding during the periods
• Milk coming out of the breasts in the absence of pregnancy (galactorrhea, hyperprolactinemia)
• Putting on excess weight, increased growth of hair (hirsutism) and acne, which might indicate hormonal imbalance
• Problems with erection and ejaculation in men
• Swelling or pain in the testes
• Production of a very small volume of semen in men
• Inability to conceive although a young couple do not apply contraception for a year.
• Inability to conceive during a period of 6 months if the individuals are older than 35 years old.